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Licensing details for: 10353

Name: CLAIREMONT PEDIATRIC DENTAL PRACTICE OF KHUONG NGUYEN, DDS, A PRO

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Previous Names: CLAIREMONT PEDIATRIC DENTAL

Address of Record

2780 CARDINAL ROAD, STE. A
SAN DIEGO CA 92123
SAN DIEGO county
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Practice Location

2780 CARDINAL ROAD, STE. A
SAN DIEGO CA 92123
SAN DIEGO county
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Issuance Date

March 11, 2013

Expiration Date

September 30, 2022

Current Date / Time

June 6, 2025
9:58:52 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: NGUYEN, KHUONG HUU

Address Not Disclosed

FNP to DDS or OMS

License/Registration Role: Fictitious Name Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: NGUYEN, KHUONG HUU

License/Registration Type: Dentist License

License Number: 44965 Primary Status: Current - Active

Address :
3028 McCall St
SAN DIEGO CA 92106-3423
SAN DIEGO COUNTY

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